Thursday, May 18, 2017

Côte d'Ivoire - Trip Notes

Travel Dates - 18 - 22 April 2017


I traveled to Côte d'Ivoire for the purpose of exploring research opportunities for UNC Gillings faculty and practicum opportunities for students.  Early in my global public health career I worked in Côte d'Ivoire for the U.S. CDC, based in the Office of Statistics within the Ministry of Public Health and Hygiene.  I still have a number of professional contacts there with whom I connected for this trip.

Briefly, Côte d'Ivoire is a West African country similar in size to the state of New Mexico with an estimated population of 23 million (2016), about 50% of whom are under age 20. About 5.1 million Ivoirians (23%)  live in Abidjan, a port city and defacto business capital located between lovely lagoons along the southeastern coast of the country. 
Downtown Abidjan

Economic Profile

Côte d'Ivoire is important to U.S. government interests, with 2016 overseas development assistance (ODA ) funding at $144 million[1], its rich natural resources (cocoa, cashews, coffee, oil, gas, minerals, etc.) and stable government and increasingly strong economic growth (9% GDP in 2015).

Côte d'Ivoire offers several research, training, and service opportunities that may be attractive to UNC school of public health faculty and students in an environment supportive of the school's mission to address “big public health problems with scalable solutions.” 

While still an economy largely dependent on rural agriculture, Côte d'Ivoire is crossing the tipping point to become a middle income country[2], given gross national income (GNI) growth per captia has increased 64% from $942 in 2005 to $1546 in 2014.  According to The World Bank, Côte d’Ivoire is the largest economy in the West African Economic and Monetary Union, as the world’s top exporter of cocoa and raw cashew nuts, a net exporter of oil, and with a significant and emerging manufacturing sector. 

Health Profile

According to UNICEF's most recent Multiple Indicator Cluster Surveys (MICS), Côte d'Ivoire has made steady and positive progress in basic health and economic indicators between 1990 and 2012.  For example, there has been a 27% and 29% decline in under-one and under-five mortality rates, respectively, DPT3 and Polio3 immunization rates at nearly 95% in 2012, and total fertility rate that has declined by 23% from 6.4 births per woman in 1990 to 4.9 births in 2012.  About 18% of the population of reproductive age used modern contraceptives and adult HIV+ prevalence was 3.2% in 2012. 

Ministry of Health and Public Hygiene (MOPH) Ministère de la Santé et de l'Hygiène Publique
L-R: Drs YEO, ADOURI, NIANGUE, HERRINGTON, and KOUAME
I met with Dr. NIANGUE Joseph, Director of Cabinet, MOPH, with whom I worked in the late 1980s on the CDC Africa Child Survival Initiative - Combatting Childhood Communicable Diseases Project when Dr. NIANGUE was a District Medical Officer in Aboisso department.  Dr. NIANGUE assembled the following group of his colleagues, including Dr. KOUAME Desires, Director of NGO Services,  Prof ADOURI Innocent, Director of Cancer, and Dr. YEO Ali Frederick, Institute for Public Health, who investigates falsified medicines, for our discussion.  All were enthusiastic about UNC interest in engagement with Côte d'Ivoire.


There are several national research institutes within the MOPH worth consideration by UNC public health researchers, particularly those interested in the following areas:
Pasteur Institute in Côte d'Ivoire (Institut Pasteur en Côte d'Ivoire - IPCI)
Established in Côte d'Ivoire in 1972, IPCI is under the jurisdiction of the Ministry of Higher Education and Scientific Research (Ministère de l’Éducation Supérieur et de la Recherche Scientifique) and has been part of the Institut Pasteur worldwide network of 33 national research sites since 1978. The IPCI mission is to "provide scientific research in the service of humanity."

I had the pleasure to meet with Professor DOSSO Mirielle [email: mireilledosso@pasteur.ci] and her team at IPCI and visit their labs in Adiopodoume (west of Abidjan) where the Institute has created a cryobiology room of 480 square meters with a capacity for twenty 1000 liter cryotanks that will hold over 7 million specimens.   The establishment a biobank in Côte d'Ivoire represents smart and strategic long-term thinking, as it would strengthen and enable African scientists to carry out proteomic and genomic studies to develop vaccines and other intervention tools against Ebola, Zika, Lassa and other infectious diseases, as well as studies to address non-communicable diseases, such as cervical and breast cancers, diabetes, and cardiovascular illnesses that are becoming increasingly prevalent in West Africa, as life expetancy increases and the epidemiologic transition occurs in the region.   There have been published calls for establishment of biobanks in low-resource countries as an "alternate paradigm of biomedical research that relies on human biobanks [that] is not dependent on ‘a priori’ hypotheses, because it can simply apply rigorous statistical methods to search for apparent associations [see NIH genome-side association studies - GWAS data sharing] between thousands or millions of variables that were measured simultaneously in a very
https://www.whi.org/
large sample of participants, using exceptionally precise (and increasingly inexpensive) measurement tools, while correcting for and discarding false-positive results expected due to multiple testing [3]."  To this end, a cadre of Ivorian biostatisicans will be necessary for such research to be accomplished locally, an expressed desire by Director DOSSO, who is a professor of microbiology.

Student Practica
The U.S. Embassy in Abidjan is eager to support U.S. students studying in Côte d'Ivoire, per Nina R. Toyo, EducationUSA Advisor,  [tel. (225) 22 49 41 45 / 22 49 42 16, https://www.facebook.com/EducationUSA RCI Toyo and http://www.educationusa.state.gov], and creating study abroad/exchange programs between UNC Chapel Hill and institutions in Côte d’Ivoire.


  
The International University of Grand Bassam (IUGB) is a four-year English-only undergraduate private institution located about 30 min south of Abidjan.  Started with support from former U.S. Ambassador to the United Nations, Andrew Young, "IUGB is an independent, not-for profit, American-style institution whose focus is to produce workforce-ready innovative, entrepreneurial, and socially responsible leaders."  I met with Vice Provost for Academic Affairs, Dr. Ahmed LEGROURI, who explained that IUGB awards undergraduate degrees in Business Administration, Political Science, Mathematics, Computer Science, Computer Information System and Mechanical Engineering Technology with options in petroleum or manufacturing technology.  Students can also minor in International Relations, Accounting, Finance,
Economics, Marketing, Management, Computer Information Systems, Mathematics, and Computer Science.  Dr. LEGROURI indicated that IUGB is seeking accreditation from The Commission on Institutions of Higher Education (CIHE) of the New England Association of Schools and Colleges (NEASC) and intends to meet the standards and requirements for undergraduate programs per ABET or AACSB guidelines.  IUGB currently has on-going partnerships with the Georgia State University, Minnesota State Mankato, University of Arkansas, University of Alabama at Birmingham, and the University of Houston.  Dr. LEGROURI indicated IUGB would be delighted to consider a study aboard partnership with UNC Chapel Hill. 
In sum,
I would encourage UNC students, particularly those who are francophones, to let me know if you are interested in research opportunities in Côte d'Ivoire and I'd be happy to make relevant connections with CDC, USAID, and the MOPH.

Bonne arrivée,

Jim





[1] http://beta.foreignassistance.gov/explore
[2] https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups 
For the current 2017 fiscal year, low-income economies are defined as those with a GNI per capita, calculated using the World Bank Atlas method, of $1,025 or less in 2015; lower middle-income economies are those with a GNI per capita between $1,026 and $4,035; upper middle-income economies are those with a GNI per capita between $4,036 and $12,475; high-income economies are those with a GNI per capita of $12,476 or more.
[3] "Developing biobanks in developing countries" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3484738/ 

 





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Location: Côte d'Ivoire